文章摘要
李加雄,李丹,金晓菲,等.基于宏基因组测序的检测技术诊断呼吸道感染性疾病 92例[J].安徽医药,2023,27(11):2261-2264.
基于宏基因组测序的检测技术诊断呼吸道感染性疾病 92例
Diagnosis of respiratory tract infectious diseases in 92 cases based on metagenomic sequencing
  
DOI:10.3969/j.issn.1009-6469.2023.11.032
中文关键词: 呼吸道感染  宏基因组测序  诊断作用  检测方式
英文关键词: Respiratory tract infections  Metagenomic sequencing  Diagnostic function  Testing way
基金项目:
作者单位E-mail
李加雄 深圳市龙岗区第二人民医院呼吸内科广东深圳 518000  
李丹 深圳市龙岗区第二人民医院呼吸内科广东深圳 518000  
金晓菲 深圳市龙岗区第二人民医院呼吸内科广东深圳 518000  
刁振华 深圳市龙岗区第二人民医院呼吸内科广东深圳 518000  
卢惠伦 深圳市龙岗区第二人民医院呼吸内科广东深圳 518000  
游世伦 深圳市龙岗区第二人民医院呼吸内科广东深圳 518000 flower3379@163.com 
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中文摘要:
      目的分析基于宏基因组测序的检测技术对呼吸道感染性疾病的诊断作用,以期为该病的诊断提供一种有效的手段。方法选取 2019年 6月至 2021年 7月深圳市龙岗区第二人民医院收治的 92例呼吸道感染性疾病病人纳入研究。采集所有受试者的肺泡灌洗液作为标本,分别进行基于宏基因组测序检测以及传统检测方式诊断。比较不同检测方式检出病原体情况。以所有受试者出院时诊断结果作为“金标准”分析不同检测方式诊断呼吸道感染性疾病灵敏度、特异度及准确度。结果宏基因组测序检测共检出 45例病原体阳性,传统检,测方式共检出 40例病原体阳性,两种检测方式对细菌、真菌、巨细胞病毒、结核分枝杆菌以及非结核分枝杆菌的检出率对比均差异无统计学意义(均 P>0.05);宏基因组测序检测的复数病原检出率为19.57%(18/92),高于传统检测方式的 8.70%(8/92),差异有统计学意义( P<0.05)。宏基因组测序检测技术共检出呼吸道感染性疾病 47例,其中 2例误诊, 1例漏诊,传统检测方式共检出呼吸道感染性疾病 48例,其中 8例误诊, 6例漏诊。宏基因组测序检测诊断呼吸道感染性疾病灵敏度、特异度及准确度分别为 97.83%(45/46)、 95.65%(44/46)、96.74%(89/92),均高于传统检测方式的 86.96%(40/46)、 82.61%(38/46)、 84.78%(78/92),均差异有统计学意义(均 P<0.05)。结论基于宏基因组测序的检测技术对呼吸道感染性疾病的诊断作用较佳,明显优于传统检测方式,值得临床推广应用。
英文摘要:
      Objective To study the diagnostic function of metagomenic sequencing based detection technology for respiratory tractinfectious diseases,so as to provide an effective method for the diagnosis of patients with this disease.Methods A total of 92 patientswith respiratory tract infection were included in the Second People′s Hospital of Longgang District from June 2019 to July 2021.Samples of alveolar lavage fluid were collected from all subjects for diagnosis based on metagenomic sequencing and traditional methods.Compare the pathogen detected by different detection methods. The sensitivity,specificity and accuracy of different detection methodsin the diagnosis of respiratory tract infectious diseases were analyzed with diagnosis results at the time of discharge of all subjects asthe "gold standard".Results A total of 45 cases were detected positive for pathogens by metagenomic sequencing, and 40 cases weredetected positive for pathogens by traditional detection method. The detection rates of bacteria, fungi, cytomegalovirus, mycobacteriumtuberculosis and non-tuberculous mycobacterium were not significantly different between the two detection methods (all P>0.05).Thedetection rate of complex pathogens by metagenomic sequencing was 19.57 % (18/92),which was higher than 8.70 % (8/92) by traditional method, and the difference was statistically significant (P<0.05). A total of 47 cases of respiratory tract infectious diseases were detected by metagenomic sequencing, among which 2 cases were misdiagnosed and 1 case was missed. A total of 48 cases of respiratorytract infectious diseases were detected by traditional detection, among which 8 cases were misdiagnosed and 6 cases were missed. Thesensitivity, specificity and accuracy of metagenomic sequencing in the diagnosis of respiratory infectious diseases were 97.83 % (45/46), 95.65 % (44/46) and 96.74 % (89/92), respectively, which were significantly higher than 86.96 % (40/46), 82.61 % (38/46) and 84.78 % (78/92) of traditional detection methods, with statistical significance (all P<0.05).Conclusion Metagenomic sequencing hasa better diagnostic effect on respiratory tract infectious diseases, which is obviously better than traditional detection methods, and isworthy of clinical application.
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